Pandemic prevention

from Wikipedia, the free encyclopedia
Important information is missing from this article or section. Help Wikipedia by researching and pasting it .

Pandemic prevention is the organization and management of preventive measures against pandemics . This includes measures to minimize the causes of pandemics and measures to prevent regional outbreaks or epidemics from developing into pandemics. Pandemic prevention can also refer to preventive measures aimed at mitigating the harmful effects of future or ongoing pandemics.

history

In 2003 it was possible to prevent the SARS-CoV from leading to a pandemic. Quick action by national and international health organizations such as the World Health Organization made it possible to slow down the spread and ultimately break the chains of transmission. This ended the epidemic before it could develop into a pandemic. Effective patient isolation was sufficient to stop the spread, since infected people usually did not spread the virus until a few days after the first symptoms.

activities

Infrastructure and international development

Pandemic prevention requires resilient healthcare systems that act quickly and work together to prevent contagion. For a certain time after an outbreak, a pandemic can still be prevented by the responsible authorities isolating the first infected and / or fighting the pathogen. A good global infrastructure, consistent exchange of information, short routes in bureaucracy and effective, targeted treatment methods can all be prepared. In 2012, it was proposed to consider pandemic prevention as an aspect of international development aid. This includes building the infrastructure of health systems and changing the pathogen-related dynamics between humans and the environment, including animals. Community nurses or doctors in Africa, Asia or Latin America often discover unusual clusters of symptoms, but they often lack the opportunity to investigate more closely. In February 2020, scientists write that "research that should be prioritized for countries with weaker surveillance, laboratory capacities and health systems" and that "in these regions vaccine delivery routes should not depend on refrigeration and diagnostics should be available locally".

Non-pharmaceutical public health interventions

The WHO defines non- pharmaceutical public health interventions as all measures and actions other than vaccines and drugs that can be used to reduce the spread. This includes measures of personal protection (hand hygiene , sneeze labels , breathing masks), environmental measures (surface cleaning , other measures such as ventilation or air conditioning), measures of social distancing (contact tracking, isolating sick people, quarantine for contact persons, restrictions and closings with regard to workplace, workplace measures and closures, avoidance of crowds), travel measures (travel warnings, border checks, travel restrictions within the country, border closings).

Contact reduction and follow-up and self-isolation

To contain a highly infectious epidemic, it is essential to stop chains of infection. Especially as long as no vaccines are available, it is crucial that the infected isolate themselves and that contact persons of the infected isolate themselves.

When asked about measures to contain COVID-19 infections such as physical distancing and the wearing of respiratory masks , David Nabarro, WHO's special envoy for the COVID-19 pandemic, emphasized the particular importance of quarantining infected people and their contact persons at home in April 2020:

"The most important thing to do is to isolate yourself when you have symptoms, and make sure all those with whom you've been in contact recently isolate themselves as well."

"The most important thing is to isolate yourself when you have symptoms and to ensure that everyone with whom you have been in contact lately also isolates yourself."

According to Nabarro, this is primarily a question of a social habit: to take even mild symptoms seriously and to keep your distance accordingly.

Technologies

Pathogen detection and prediction

A 2012 study claims that "mathematical modeling, diagnostic, communication and information technologies can identify and report previously unknown microbes and other species" and "therefore new risk assessment approaches are needed to identify the most likely microbes cause human diseases to identify ". The study examines challenges in transforming the global strategy for dealing with pandemics from responding to prevention. Some scientists examined blood samples from wild animals for new viruses. The international Global Virome Project (GVP) tries to identify the causes of deadly new diseases before they transition into humans. For this, viruses found in wild animals are genetically characterized. Edward Rubin notes that after sufficient data has been gathered artificial intelligence could be used to identify common features and develop countermeasures and vaccines against whole categories of viruses. It might be possible to predict viral evolution using machine learning . Funding for the US PREDICT research program, which sought to identify animal pathogens that could infect humans and prevent pandemics, was cut in 2019. Funding for US CDC programs to train workers to detect outbreaks and improve laboratory and emergency response systems in countries where disease risks are highest to contain outbreaks at the source increased by 80% in 2018 shortened.

CRISPR-based immune subsystems

In March 2020, scientists from Stanford University presented a CRISPR -based system that can find and destroy viruses in vitro . However, they were unable to perform their tests of the "PAC-MAN" system (Prophylactic Antiviral Crisp in huMAN cells) on the real SARS-CoV-2 . In addition, they used a targeting system that uses only a very limited region of RNA and did not develop a delivery system for delivery into human cells. In addition, it would take a long time for an improved version of the system or a successor to pass the tests including the clinical studies . In the study, which was published as a preprint , they write that the system could be used both prophylactically and therapeutically. The CRISPR-13d -based system is agnostic towards the virus it is supposed to fight: novel coronavirus strains or other viruses would only require a small change that could be implemented quickly. In an editorial published in February 2020, another group of scientists claims that they have implemented a flexible and efficient approach to gene targeting of RNA using CRISPR-Cas13d technology, their system is already being reviewed and also on SARS-CoV -2 can be aligned. There were several successful attempts to fight viruses in human cells with CRISPR-based technologies before 2020.

Tests and containment

CDC 2019-nCoV Laboratory Test Kit.jpg
A SARS-CoV-2 laboratory test kit from the CDC

The early use and development of rapid tests for new viruses , in combination with other measures, could make it possible to prevent chains of transactions from outbreaks before they develop into pandemics. A high detection rate is important for tests. For this reason, no thermal scanners with a low detection rate were used to contain the swine flu pandemic in 2009 . In the German research program InfectControl 2020 , which is funded by the Federal Ministry of Education and Research , attempts were made to develop strategies for the prevention, early detection and control of infectious diseases. In the "HyFly" project of the program, partners from industry and research are developing strategies to curb chains of infection in air traffic, to establish effective preventive countermeasures and to draw up specific recommendations for action for airport operators and airlines. One approach of the project is to detect infections quickly and without the use of molecular biological methods during passenger control at the airport. For this purpose, researchers at the Fraunhofer Institute for Cell Therapy and Immunology are developing a non-invasive method based on ion mobility spectrometry (IMS).

Surveillance and mapping

Monitoring people exposed to animals in virus hotspots could identify viruses the moment they enter humans. This could prevent pandemics. Virus monitoring stations could also be used for this purpose. The most important transmission route usually varies depending on the underlying cause - in the case of a change in land use, for example, direct contact with an animal. Land use change is the most common reason for novel zoonoses according to the number of occurrences according to Jones et al. (2008). 75 percent of the 1415 species of infectious organisms examined up to 2001 that are pathogenic for humans are zoonoses. Genomics could be used to track virus evolution and transmission accurately and in real time through a large and biodiverse population. To this end, the pathogen genome could be combined with data on host genetics and the specific signature of the transcriptional response of the immune system to the infection. The "Surveillance, Outbreak Response Management and Analysis System" (SORMAS) of the Helmholtz Center for Infection Research (HZI) and the German Center for Infection Research (DZIF), which work together with Nigerian researchers, collects and analyzes data in the event of an outbreak and detects potential threats and enables protective measures to be initiated at an early stage. It is especially intended for poorer regions and has been used to control a monkeypox -Ausbruchs in Nigeria used.

Regulation and economy

According to an analysis from 2014, the window of opportunity to deal with pandemics as a global community is still around 27 years open. Pandemic prevention should therefore be a critical health policy issue for and addressed by the current generation of scientists and policy makers. A 2007 study warns, "The presence of a large reservoir of SARS-CoV-2-like viruses in horseshoe bat bats, along with southern China's culture of eating exotic mammals, is a time bomb. The possibility of SARS recurrence and other novel animal or laboratory viruses should not be underestimated. Hence the need for preparedness should not be ignored "(translated from English). According to a sociologist, large sections of the population are on the alert as soon as they can no longer be ruled out that they are personally affected, for example by pandemics, which increases their willingness to spend money on their own protection. The US National Security Council Directorate for Global Health Security and Biodefense, which was concerned with taking precautions for the next disease outbreak and preventing it from developing into an epidemic or pandemic, closed in 2018.

Environmental policy and sustainable business

Linking pandemic prevention to environmental policy, some experts point out that environmental degradation and climate change are causing wildlife to live close to humans. For example, the WHO projects that climate change will increase the incidence of infectious diseases . A 2016 study reviews the scientific literature on the effects of climate change on infectious diseases, suggests a range of proactive measures to control health effects, and concludes that climate change affects infectious diseases through changes in pathogens, hosts and transmission routes. Studies have shown that the risk of infectious disease outbreaks can be greatly increased after deforestation . James Holland Jones, a bioanthropologist at Stanford University, writes that mankind has "constructed a world in which infectious diseases are both more likely and more likely to have consequences," referring to the common lifestyle of frequent travel and increasingly populous cities and diverse types of human interactions with and changes in the environment.

Regulation of research and development in biotechnology

Toby Ord questions whether current public health and international conventions, as well as the self-regulation of biotechnology companies and the scientific community, are adequate. During the 2019-2020 coronavirus pandemic, Neal Baer writes that "the public, scientists, MPs and others" "should now have a thoughtful conversation about genetic engineering" (translated from English).

Food markets and wildlife trade

Poultry in cages at a wet market in Shenzhen , China

In January 2020 - during the SARS-CoV-2 outbreak - experts inside and outside China warned that wildlife markets from which the virus is likely to originate should be banned worldwide. On January 26, China banned wildlife trafficking until the coronavirus epidemic ended. A permanent ban on trade and consumption of wild animals was imposed on February 24, with a few exceptions. Some scholars point out that banning informal wet markets around the world is not the right answer, as refrigerators are not available in many places and a large proportion of food in Africa and Asia is sourced through such traditional markets. Some also say that simple bans could lead traders to black market trades, where they would likely be less hygienic. Some also suggest that it is wildlife, not farm animals, that are the natural hosts of many viruses.

International coordination

The Global Health Security Agenda (GHSA) is a network of countries, international organizations, NGOs and companies that work together to improve the capacity to prevent, detect and respond to infectious diseases. As of February 2020, 67 countries have already joined the framework. Funding for the GHSA has been reduced globally and within the USA since it was founded in 2014. In a lecture in Boston in 2018 , Bill Gates called for a global effort for a comprehensive system for preparing and responding to pandemics.

Artificial Induction of Immunity

vaccination

New vaccines typically take years to develop and deliver. The Coalition for Epidemic Preparedness Innovations , founded in 2017, is working to reduce vaccine development time. In a preprint that was published on March 24, 2020, scientists suggest that the unique signature of the transcriptional response of the human immune system to SARS-CoV-2 could be responsible for the development of COVID-19. SARS-CoV-2 did not activate the antiviral genes that code for type I and type III interferons . This could be relevant for the development or re-function of treatments.

antibody

Broad spectrum antimicrobials and rapid medical development, transformation and deployment

Cull

Experts warn that reducing species through culling to prevent human infection will reduce genetic diversity and thereby endanger future generations of animals and humans. Others argue that it is still the best, most practical way to contain viruses in farm animals.

Prevention versus management

Pandemic prevention seeks to prevent pandemics, while pandemic control seeks to limit the extent of pandemics and minimize their negative effects. Some people call for a change from a treatment-oriented society to a prevention-oriented society. In a study from 2010, for example, researchers write that global disease control is almost exclusively focused on only reacting to pandemics after they have spread globally. You write that developing systems to prevent new pandemics before they occur should be seen as essential to human health.

See also

literature

Individual evidence

  1. ↑ a b Pandemic prevention: Gaining time in an emergency
  2. ↑ WHO | SARS outbreak contained worldwide .
  3. ^ SARS: How a global epidemic was stopped . Retrieved March 25, 2020.
  4. ^ The World Bank Group A to Z 2015 . World Bank Publications, 2014, ISBN 978-1-4648-0382-6 , pp. 119 (English).
  5. ↑ Mark Jackson: The Routledge History of Disease . Routledge, 2016, ISBN 978-1-134-85787-6 , pp. 140 (English).
  6. ↑ Combating pandemics The next outbreak is sure to come . Retrieved March 30, 2020.
  7. ↑ , Patrick Vallance Coronavirus: global solutions to prevent a pandemic ( en ) pp. 363-363. February 18, 2020. Accessed April 3, 2020.
  8. ↑ Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza: Summary of recommendations. In: who.int. WHO, 2019, accessed April 25, 2020 . ISBN 978-92-4-151683-9 . Pp. 13-18.
  9. ↑ a b Chiara Giordano: Coronavirus: Wearing face masks in public will likely become new norm, says WHO expert. In: independent.co.uk. April 13, 2020, accessed April 20, 2020 .
  10. ^ Prediction and prevention of the next pandemic zoonosis . In: The Lancet . 380, No. 9857, September, pp. 1956-1965. doi : 10.1016 / S0140-6736 (12) 61684-5 . Retrieved March 25, 2020.
  11. ↑ Virus Hunter: How One Scientist Is Preventing the Next Pandemic ( en-us ). Retrieved March 26, 2020.
  12. ↑ a b Scientists aim to stop the devastation of Zika-like pandemics . June 24, 2018. Retrieved April 3, 2020.
  13. ^ The prediction of virus mutation using neural networks and rough set techniques . In: EURASIP Journal on Bioinformatics and Systems Biology . 2016, September. doi : 10.1186 / s13637-016-0042-0 .
  14. ^ Scientists Were Hunting for the Next Ebola. Now the US Has Cut Off Their Funding. . In: The New York Times , October 25, 2019. Retrieved March 25, 2020. 
  15. ↑ CDC to cut by 80 percent efforts to prevent global disease outbreak (en) . In: Washington Post . Retrieved March 26, 2020. 
  16. ↑ Could Crispr Be Humanity's Next Virus Killer? ( en ) Retrieved March 25, 2020.
  17. ↑ Development of CRISPR as a prophylactic strategy to combat novel coronavirus and influenza . In: bioRxiv . September. bioRxiv : 10.1101 / 2020.03.13.991307v1 ( preprint - full text). doi : 10.1101 / 2020.03.13.991307 .
  18. ↑ , Yang Zhang Virus against virus: a potential treatment for 2019-nCov (SARS-CoV-2) and other RNA viruses ( en ) pp. 189–190. March 2020. Accessed April 1, 2020.
  19. ↑ Scientists Program CRISPR to Fight Viruses in Human Cells ( en ) October 23, 2019. Retrieved April 1, 2020.
  20. ↑ Combatting Viruses with RNA-Targeted CRISPR ( en ) Retrieved April 1, 2020.
  21. ↑ Recent advances in diagnostic testing for viral infections . In: Bioscience Horizons: The International Journal of Student Research . the 9th of September. doi : 10.1093 / biohorizons / hzw010 . Retrieved March 26, 2020.
  22. ^ Metagenomics for the discovery of novel human viruses . In: Future Microbiology . 5, No. 2, September, pp. 177-189. doi : 10.2217 / fmb.09.120 . Retrieved March 26, 2020.
  23. ↑ Development and Initial Results of a Low Cost, Disposable, Point-of-Care Testing Device for Pathogen Detection . In: IEEE Transactions on Biomedical Engineering . 58, No. 3, September, pp. 805-808. doi : 10.1109 / TBME.2010.2089054 . Retrieved March 26, 2020.
  24. ↑ Experts against thermal scanners at airports
  25. ↑ InfectControl 2020 - InfectControl 2020 . Retrieved April 1, 2020.
  26. ↑ Hygiene through architecture instead of antibiotics . April 1, 2020. Accessed April 1, 2020.
  27. ↑ Pandemic prevention at the airport
  28. ↑ Opinion | How to Prevent a Pandemic . April 29, 2009. Retrieved March 25, 2020.
  29. ↑ Targeting Transmission Pathways for Emerging Zoonotic Disease Surveillance and Control . In: Vector Borne and Zoonotic Diseases . 15, No. 7, September, pp. 432-437. doi : 10.1089 / vbz.2013.1563 .
  30. ↑ a b c d Coronavirus: 'Nature is sending us a message', says UN environment chief . March 25, 2020. Accessed March 25, 2020.
  31. ^ Risk factors for human disease emergence . In: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences . 356, No. 1411, September, pp. 983-989. doi : 10.1098 / rstb.2001.0888 . PMID 11516376 .
  32. ↑ Genomic Signatures of Emerging Viruses: A New Era of Systems Epidemiology . In: Cell Host & Microbe . 19, No. 5, September, pp. 611-618. doi : 10.1016 / j.chom.2016.04.016 . Retrieved March 26, 2020.
  33. ↑ Pandemic Prevention in Nigeria
  34. ↑ https://sormasorg.helmholtz-hzi.de/
  35. ↑ Economic optimization of a global strategy to address the pandemic threat . In: Proceedings of the National Academy of Sciences . 111, No. 52, September, pp. 18519-18523. doi : 10.1073 / pnas.1412661112 . Retrieved March 25, 2020.
  36. ↑ Severe Acute Respiratory Syndrome Coronavirus as an Agent of Emerging and Reemerging Infection . In: Clinical Microbiology Reviews . 20, No. 4, September, pp. 660-694. doi : 10.1128 / CMR.00023-07 . Retrieved March 25, 2020.
  37. ^ Pandemics - horror scenarios between fear and fascination
  38. ^ A b Now is the time to revise the Global Health Security Agenda . March 27, 2020. Accessed April 1, 2020.
  39. ↑ Perspective | I ran the White House pandemic office. Trump closed it. ( en ) Retrieved April 1, 2020.
  40. ↑ a b 'Tip of the iceberg': is our destruction of nature responsible for Covid-19? . March 18, 2020. Accessed March 28, 2020.
  41. ↑ WHO | Climate change and human health - risks and responses. Summary. . Retrieved March 27, 2020.
  42. ↑ Impact of climate change on human infectious diseases: Empirical evidence and human adaptation . In: Environment International . 86, September, pp. 14-23. doi : 10.1016 / j.envint.2015.09.007 . Retrieved March 27, 2020.
  43. ^ How Forest Loss Is Leading To a Rise in Human Disease . Retrieved March 27, 2020.
  44. ↑ Deforestation is leading to more infectious diseases in humans ( en ) November 22, 2019. Accessed March 27, 2020.
  45. ↑ Recent loss of closed forests is associated with Ebola virus disease outbreaks . In: Scientific Reports . 7, No. 1, September, pp. 1-9. doi : 10.1038 / s41598-017-14727-9 . Retrieved March 27, 2020.
  46. ^ Deforestation and avian infectious diseases . In: The Journal of Experimental Biology . 213, No. 6, September, pp. 955-960. doi : 10.1242 / jeb.037663 .
  47. ^ Stanford: How Humanity Has 'Engineered a World Ripe for Pandemics' . March 28, 2020. Accessed April 3, 2020.
  48. ↑ Why we need worst-case thinking to prevent pandemics . March 6, 2020. Accessed April 1, 2020.
  49. ↑ Could a rogue scientist use CRISPR to conjure another pandemic? . March 26, 2020. Accessed March 27, 2020.
  50. ↑ Calls for global ban on wild animal markets amid coronavirus outbreak . In: The Guardian , January 24, 2020. Retrieved March 25, 2020. 
  51. ↑ China bans wild animal trade until coronavirus epidemic is eliminated (en) . In: Washington Post . Retrieved March 25, 2020. 
  52. ↑ China's Ban on Wildlife Trade a Big Step, but Has Loopholes, Conservationists Say . In: The New York Times , February 27, 2020. Retrieved March 25, 2020. 
  53. ↑ CDC Global Health - CDC and the Global Health Security Agenda ( en-us ) February 19, 2020. Accessed April 1, 2020.
  54. ↑ Global Health Security Agenda ( en ) Retrieved April 1, 2020.
  55. ↑ a b c Bill Gates Calls For, And Funds, Steps To Prevent A Global Pandemic ( en ) Retrieved April 1, 2020.
  56. ^ The next epidemic is coming. Here's how we can make sure we're ready. . Retrieved April 1, 2020.
  57. ↑ Cells' Response to SARS-CoV-2 Different from Flu, RSV ( en ) Accessed April 1, 2020.
  58. ↑ Pandemic prevention schemes threaten diversity, experts warn ( en ) pp. 598-598. June 1, 2006. Accessed March 25, 2020.
  59. ^ Self-efficacy, Threat, Knowledge, and Information Receptivity: Exploring Pandemic Prevention Behaviors to Enhance Societal Welfare . In: Academy of Health Care Management Journal . September. Retrieved March 25, 2020.
  60. ^ The Origin and Prevention of Pandemics . In: Clinical Infectious Diseases . 50, No. 12, September, pp. 1636-1640. doi : 10.1086 / 652860 . Retrieved April 4, 2020.